Stefan Launer, VP Science & Technology

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1 Stefan Launer, VP Science & Technology 1

2 2 Introduction The world we live in will change Always on - connectivity Technologies for our products Mechanical design: product design and style Connectivity: Wireless technology Functionality Services Borader range and different focus of application Tinnitus, APD, telehealth 2

3 The environment we live in will be different Technical and societal The technology we will be using will be different The future of hearing health care and it s education will be different How people communicate will be different Change is needed: penetration of hearing instruments still very low Different countries, different needs regarding hearing health care provision process 3

4 1910 4

5 Robert Sloss, 1910, Das Telephon in der Westentasche,.. Will connect everyone with everyone... just type the numberand call... Receive messages... Listen to music... Watch movies... Participate in telephone or video conferences... Join in any event or any catastophies in the world live while happening... The world will be a single place we live in... Skype, e-vote, GPS und Navigation, e-newspaper Change in life style and social interaction 5

6 Was macht das Digitale Dorf aus? Digital content & information Lokale Neuigkeiten (Vereine, Veranstaltungen, BLOGs) Globale Inhalte (News, Wikis, Publikationen, ) Information retrieval (Google) Digital community Soziale Netzwerke (WhatsApp, Twitter, Facebook und Picasa) Verstärkung oder Ersatz von lokalen Gemeinschaften (Vereine, Freundschaften, Stammtischen, ) Ergänzung um globale Gemeinschaften 6

7 Was macht das Digitale Dorf aus? Digital communication Lokal und global Videokommunikation Soziales Spielen, Treffen, Fitness Notruf Digital coordination Lokaler Markt: z.b. Sharing Economy, Zeitbörsen, Tauschbörsen, Sonderangebote, Coupons, Veranstaltungen Digitale Dienstleistung: online retail, services,. Lokale Intermediäre Kommunalverwaltung, Wohnungsgesellschaft, Krankenhaus, Vereine, Kirchen Qype, Around-me, Google, Directories, Globale Coordination: Amazon, ebay, Google, airbnb, 7

8 Wearables: available examples: Infotainment, Gaming Control eye blink, eye tracking Buhel Helmet Communication System Google Glasses THUMP 2digial music eyewear O.R.B. headset capable of hands-free calling Recon Alpne Googles with GPS Vusix Smart Glasses 8

9 Amiigo Fitness Band GOW Heart Rate Monitor Jawbone tracks movement Nike Fuelband: calories burned TmG moniot muscel fatique 9

10 Wearables: available examples: Wellbeing & Health First Warning Breast System Philips Bilirubin Blanket Preventice: remote monitoring of non-lethal cariac arrhytmias WatchMinder: aid children with with Attention Deficit Disorder by vibrating Whihings: Blood pressure Everon: mobility and security for10 elderly

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12 Interactive Homes, interactive Living 12 Convenience Smart power management Ambient assisted living 12

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15 Launched in Q after a successful pilot in Ohio, HealthSpot provides consumers with access to a doctor via its telemedicine kiosks. Connecting doctors with patients via HD video-conferencing, the walk-in kiosks are installed in locations such as retail spaces. Each HealthSpot kiosk is equipped with basic medical instruments, including a stethoscope and digital thermometer. A HealthSpot visit costs USD HealthSpot Kiosks offer video conferencing with health professionals 15

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18 Quantified self: getting insight into one s health and lifestyle 18 DRIVERS: Personal Growth Health awareness Big Data SOCIAL SELF MONITORING Connecting and sharing with Others DRIVERS: Social media From me to we Shareconomy Having an extra Layer of experience DRIVERS: Wearable Tech Internet of Things Digital Lifestyle 18

19 Always having online Access DRIVERS: Digital natives Mobile Technology Busy lifestyles SMART LIFE 19 ALWAYS ON Being empowered to decide and do things one-self DRIVERS: Autonomy Distrust Social media EMPOWERED Having things Automatically done for you DRIVERS: Big data Internet of things Busy lifestyles 19

20 A CENTURY OF MINIATURIZATION Electronics Body worn Transistor Integrated circuit 20

21 AFTER 1990: UNDERSTANDING OF PERCEPTUAL CONSEQUENCES OF COCHLEAR HEARING LOSS INTRODUCTION OF DIGITAL TECHNOLOGY HEARING INSTRUMENTS TRANSFORMED FROM AMPLIFIERS TO SIGNAL PROCESSORS! 22

22 23 Digital signal processing (dsp) generation I 23

23 24 Digital signal processing (dsp) generation II 24

24 25 Digital signal processing (dsp) generation III 25

25 26 Modern hearing systems are intelligent systems with. a portfolio of solutions for different listening and communication situations 26

26 CURRENT TECHNOLOGY FOCUS: HEARING AND COMMUNICATION IN DAILY LIFE Speech intelligibility Language learning Speech production Sound quality Authenticity Feedback Management Authentic & natural Sound Recover Amplification Multichannel Compression Perception Processing 27

27 SPEECH INTELLIGIBILITY IN DEMANDING LISTENING CONDITIONS 28

28 PORTFOLIO OF SOLUTIONS FOR DIFFERENT LISTENING CONDITIONS Noise Reverberation Wind Noise Directional Microphone Adaptive and Multichannel directional Microphone Remote Microphone Roger Binaural Voice Stream Technology 29

29 Objectives for a hearing instrument: Speech intelligibility improvement!!!! Ease of listening, listening effort, listening comfort Techniques Multi-microphone Single microphone Different solutions for different listening environments Variables: Environment Positioning on head Acoustic coupling 30

30 Usability Engineering becomes important!

31 32 ITE shrinking - 3D printing and design technologies 32

32 MAIN APPLICATIONS FOR HEARING AIDS TREND TOWARDS WIRELESS LINK COMMUNICATION Application: Transmitting the voice of a distant speaker or the sound provided by a thirdparty device to the hearing instrument Challenges: Background noise Ease of use Distance Interference Binaural Application: Transmitting a control-signal and/or streaming sound between two hearing instruments Challenges: Power consumption Interference FITTING CONNECTIVITY Application: Transmitting a controlsignal and/or streaming sound from a third-party device to the hearing instrument Challenges: Compatibility Power consumption Reliability Interference Application: Adjusting hearing aid settings to an individual s hearing loss Challenges: Reliability Interference 33

33 Binaural VoiceStream Technology Feature(s) making use of Better Ear effect?» Listening to side auto ZoomControl Car, Restaurant, outdoors / wind» Binaural Telephone DuoPhone» Feedback management» Feature(s) making use of Binaural directivity?» Speech in noise in front StereoZoom». 35

34 Noise Noise Noise Noise 36 Why hearing aids are sometimes not enough Loud bar StereoZoom Noisy restaurant Directional Quiet environment Omni microphone Phonak RemoteMic Distance Distance Face to face Up to 10 meters 36

35 MICROELECTRONIC KEEPS SHRINKING: COMPUTATIONAL POWER KEEPS GROWING! Algorithms improving specific listening conditions Dynamic listening situations: Speaker identification and tracking Binaural Voice Stream Technology Reverberation Performance/robustness in various listening environments SoundRecover: more hearing losses SoundFlow Whistle Block Feedback Management Broader range of hearing losses Music perception SYSTEM INNOVATION RATHER THAN SINGLE FEATURE INNOVATION! 37

36 38

37 A Broader perspective on Product innovation DSP Feature Innovation New Product Formats RIC / Lyric / CROS Fitting Personalization Services Product Design and Styles 39

38 New product formats help to overcome challenges in Usability ~50mm New Product Formats Different user needs: - Invisible - Hassle free ~16mm 12.5 ~12mm mm 40

39

40 REHABILITATION OF SENSORINEUREAL HEARING LOSS HEARING => COGNITION AND COMMUNICATION! Cognitive aspects: listening effort, memory Auditory processing, language development Sound quality and comfort, authenticity Speech (sound) audibility Speech intelligibility 42

41 SENSORINEURAL HEARING LOSS COMORBIDITIES Tinnitus Dizziness / Fall Auditory Processing Disorders Sensorineural Hearing Loss Cardiovascular Dementia Diabetes 43

42 WIRELESS COMMUNICATION TECHNOLOGY POTENTIALLY ALSO HELPFUL FOR OTHER AUDIOLOGICAL DISORDERS Auditory Processing Disorders Dyslexia (Kraus et al) Autism (Rance et al) FM SYSTEMS / ROGER SOLUTIONS AVAILABLE! 44

43 DE-MYSTIFED: GOOD UNDERSTANDING OF TINNITUS Counseling Audiologist Patient Individually tailored sound therapy Debilitating tinnitus Population of adults who experience chronic tinnitus (10-15% of all adults) Bothersome tinnitus seek clinical intervention (~20% of all those who experience tinnitus) Non-bothersome tinnitus (~80% of all those who experience tinnitus) Source: Dobie (2004) APPROACHES FOR PROVIDING RELIEF EXIST 45

44 Counsel patient I:, patient assessment, determine tinnitus level triage Vernon 1977 Jastreboff 1990 R. Tyler 2005 J. Henry 2009 Sweetow 2010 Norena 2012 A. Moller 2012 J. Eggermont 2012 Laperre Counsel patient II: tinnitus basics, relaxation techniques, take anxiety away Treat hearing loss, improve communication and quality of life reduce stress Amplification hear environmental sounds, draw attention away from tinnitus Sound enrichment: noise through HI, additional soothing sounds refocus attention away 46

45 MOBILE DEVICES CREATE ADDED VALUE! Information- & Service Center Connectivity Remote Control Training Center, interactive fitting Computation Telehealth / teleaudiology Distant support Diagnostics STANDARDIZATION IS KEY! 48

46 49

47 TODAY: MOST ACTIVITY DURING FITTING PROCESS IN THE OFFICE OF AUDIOLOGIST / DISPENSER Awareness Counseling Fit Trial Use Today > 90 % of activity happens during fit and trial 50

48 A LOT OF OPPORTUNITIES EXIST ALONG THE CUSTOMER JOURNEY Tinnitus OTC / self fitting Remote Contro Appl E-upgrades Diagnostics Internet Sales process Product selection and demonstration Teleaudiology Cuper Awareness Counseling Fit Trial Use Consumer profiling Smart disney OFTEN CONNECTED TO E-BASED TECHNOLOGIES MobiVal Mobile fitting device Distant support 51

49 52 Expert Support Repair ediagnostic esupport ediagnostic eproposal eadjust eadapt & esupport erepair AWARENESS COUNSEL FITTING TRIAL USE 52

50 Diagnostics of various deseases incl indication for a CI Video otoscopy Using smartphone? Telesurgery-robotics (not for CI thus far) CI surgery preparation and planing, data exchange, video conferencing for consultation before and (?) during the surgery CI surgery: remote monitoring and mapping Success factors in telemedicine 53

51 Screening and diagnostics of various audiological conditions using pure tone and speech audiometry, otoacoustic emissions as well as evoked potentials Adults and children Canada, South Africa, Australia Intervention: Counseling (Tinnitus), self assessment / questionnaires, re- training (Sweden) Remote mapping and fitting of CIs (intraoperative and fine tuning the device), Remotely supported fitting of hearing instruments incl verification Telemonitoring, tele-information retrieval 54

52 TELEAUDIOLOGY MEET THE DEMAND OF GLOBAL HEARING HEALTH CARE Central Office Remote Site Highly qualified HCP Patient HCP / PERSON: WESTERN WORLD 1: DEVELOPING COUNTRIES 1:

53 Hearing the social sense 60

54 HEARING THE SUBCONSCIOUS SENSE Information about environment Context information Monitoring and warning localization 61

55 HEARING THE EMOTIONAL SENSE 62

56 Technology development: Performance, usability, design Better solutions for specific conditions Other product formats Connectivity Hearing, speech and language communication Audibility -> Intelligibility -> Auditory Cognition Hörgeräteakustiker Hearing Health Care Provider Technician -> counselling and services Customers -> engaged and empowered Different distribution channels especially for different target groups? Different countries Mild... moderate... severe 64

57 The World is an EAR 65

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